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Reader Question:

Dear HealthyFeetStore.com Blog,
I am the mother of a 3 1/2 year old boy. His left leg pronates more than his right and his right foot seems to be flatter than the other one. When I ask him to put his ankles together for me his left knee sticks inward. I’ve heard that children’s feet often pronate and that this tends to correct itself as children get older, but I’m worried that he may have flat feet because his father and grandfather have them.

What I wanted to ask was do I need to get my son orthotics or special shoes?

Can he wear sandals? I do not want to get anything that is flat and it seems all of the sandals made for kids have absolutely no arch support in them.

Any advice you could give me would be helpful. Thank you.

Podiatrist Jeff Hurless’ Answer:

Pronation is a normal motion in the hindfoot. Flat feet is a condition caused by excessive pronation. Excessive pronation also causes increased internal rotation of the lower leg bones – the tibia and the fibula; which can, in turn, place abnormal strain on the knee. You are right that it is a little too early to tell if your son’s excessive pronation will correct itself. The arch of a child’s foot has the ability to continue to develop up to approximately age seven. However, with your family’s history of having flat feet (your father and your grandfather), there is a high likelihood that your son will have flat feet as an adult.

Now, to treat or not to treat a child with asymptomatic flat feet?

I believe the answer to that is very clear: treat. One of my own three children has flat feet and there is no way I would let him go without arch supports throughout his childhood and years of development. The treatment that I recommend is simply wearing arch supports and “good” shoes. The word, “good” to me means extra supportive. The problem with a flat foot is that the foot lacks its normal intrinsic support system. So, the body uses other muscles, tendons, and bones to compensate for this lack of support. If we use shoes and arch supports to supplement the foot, then the need for compensation is reduced. The years of compensating for a foot structure abnormality is what causes problems later in life.

My recommendation for your son would be the Asics GT 2120 or Asics GT 2130 (we don’t carry it yet, but Zappos.com does) for every day normal “boy” play time and for a dressier look any of our Keeping Pace Boy’s Leather Dress / Casual Shoe. Our best selling arch support for children is the Pedag Bambini. As for children’s sandals that are “good for feet”, those have always been a very challenging category, but I would recommend the Naot Santa Cruz.

Thanks for sending your question. Best wishes for both you and your son.

Would you like to ask a podiatrist? Send your foot or shoe question to HealthyFeetStore_Content_Writer at yahoo dot com.

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